Intervention and Review Measuring outcomes for each child 1 P21

Learning Outcomes 2 To review outcomes and measure whether interventions are successful.

What are outcomes? The benefits or changes for participants that occur as a result of activities, such as:  greater knowledge  new skills  different behaviour  changes in attitude  changes in population conditions. (Hoggarth and Comfort 2010) 3

Why have an outcomes approach? 4 ‘There are downsides to the outcomes approach as there are to other systems of planning and evaluation. But the question of outcomes is a perfectly legitimate one. The number of visits made to a family is beside the point if the risks are not picked up and appropriate interventions are not identified to begin to help people deal with the problems. The number of counselling sessions provided is hardly important if in the end they made no difference for the person seeking help. We must address outcomes in order to improve services.’ (Hoggarth 2010)

Measuring change In working with children in need, and their families, the key outcome is the child’s developmental progress. The aims are to assess:  whether the child has progressed and in which dimensions  how improvements or deteriorations have come about. (Child and Family Training 2009) 5

Measuring outcomes means collecting evidence about the effects of activities and assessing whether any change achieved is partially or wholly as a result of our activities or interventions and in respect of:  the child’s development  the factors or dimensions of parenting capacity, or family and environment which are having an impact on the child’s development. 6 Measuring change

Why measure change in day to day work? 7  Helps all parties to clarify what we are trying to achieve - improves partnership working.  Keeps us focused - prevents drift - when working on longer term basis with neglected children.  Helps assess parents’ ability to respond to a child’s needs and identify what changes need to happen.  Supports service users to understand why work is taking place and therefore interventions become more meaningful.

What is meant by evidence of change?  Evidence is the information that demonstrates progress or improvement and the ‘distance travelled’.  This requires a baseline in order to be able to demonstrate that intervention has contributed to, or brought about, change or improvement.  The important issue is that information must be recorded so that change over time can be measured and that judgments of outcomes can be validated. 8

Types of measures  Recorded observations, for example, interaction between a parent and a child.  Standardised assessment, for example, completion of a questionnaire or semi-structured interview.  Testimonials, for example, a child says that they are happier at school.  Numerical, for example, school attendance records.  Objective, for example, child’s health and developmental milestones, including height and weight. 9

5 critical points Direct work with children: 1.seeing children 2.observing children in different situations 3.engaging children 4.talking to children 5.activities with children. 10

Building it into practice  Outcomes that we seek should arise from assessment of the developmental needs of a child, their parents’ capacity, and family and environment factors.  Only then can we state what we hope to change and the means by which we intend to do so. 11

12 Building it into practice

Making use of research  The outcomes we seek, and the interventions selected, should be grounded in professional knowledge and research findings.  Research into neglect contributes to the interventions we provide to achieve the planned outcomes: the importance of building resilience; developing attachment; and reducing substance misuse.  Research indicates that promising interventions include social network support, home visiting, and parent training.  BUT outcomes should be grounded in the goals that parents and children want and can achieve. 13

How to write outcomes 14 SMARTSMART Make them SMART pecific easurable chievable elevant ime what is it we are trying to measure? will it be possible to tell if an outcome has been achieved? don’t set unrealistic outcomes - intermediate outcomes (distance travelled) are important. the outcomes should regularly be derived from the assessment and professional knowledge and research. review progress.

Examples of outcomes Should be a positive statement of change or benefit for children and families and should include reference to the recipient of this change. 15 ‘There is an improvement in the physical living conditions of the child or young person.’ ‘Parent is able to respond appropriately to child’s emotional needs.’ Examples

Outcome indicators  An ‘indicator’ is a way of helping to measure progress towards achieving an outcome.  In order to measure and demonstrate movement in relation to our outcomes, we need to:  identify qualitative and /or quantitative indicators that will evidence progress and identify sources for this evidence;  choose methods and tools for collecting this evidence. 16

Examples 17 Outcome ‘ There is an improvement in the physical living conditions of the child or young person’ Outcome Indicators - how will you know if there is change?  Improvement from the baseline assessment using Home Conditions Scale.  Parents no longer at risk of losing their tenancy. (the Family Cleanliness Scale, Davie et al, 1984) Activity  Weekly home visits by volunteer befriender to support and motivate parents.  Parent training course on child safety in the home.

Measuring tools  Our every day practice in assessing children’s needs, recording and reviewing our activities to see if the planned outcomes are being met.  Tools that are valid and reliable.  Measuring Tools that are also interventions.  Clinical Scales – largely focused on psychological outcomes, but also developed for areas including educational attainment and social functioning.  Standardised questionnaires and scales. 18

Standardised questionnaires and scales 19  Strengths and Difficulties Questionnaires.  The Parenting Daily Hassle Scale.  Home Conditions Scale.  Adult Wellbeing Scale.  The Adolescent Wellbeing Scale.  The Recent Life Events Questionnaire.  The Family Activity Scale.  The Alcohol Scale. (Department of Health, Cox and Bentovim 2002))

© Triangle Consulting Outcome Star

21 Department of Health, Cox, A. and Bentovim, A. (2000) The Family Assessment Pack of Questionnaires and Scales. London: The Stationery Office. PublicationsPolicyAndGuidance/DH_ Farmer, E. and Lutman, E (2010) Case Management and Outcomes for Neglected Children Returned To Their Parents: A Five Year Follow -Up Study. Briefing note. London: Department for Education. Hoggarth, L. and Comfort, H. (2010) A Practical Guide to Outcome Evaluation. London: Jessica Kingsley Publishers. Centre for Excellence and Outcomes in Children and Young People’s Services (C4EO) Strengths and Difficulties Questionnaires Burns, S. and MacKeith, J. (2010) The Outcomes Star. East Sussex: Triangle consulting social enterprise Ltd. Online versions available Further Reading